Rheumatology Therapeutics Medical Center

Exercise and Arthritis

WHY SHOULD PEOPLE WITH ARTHRITIS EXERCISE?

People who are physically active are healthier and live longer than people who are inactive. This is true for everyone but especially for people with arthritis. In addition to the general benefits of regular exercise, certain kinds of exercise have shown important benefits for people with arthritis.

Arthritis is one of the most common reasons people give for limiting physical activity. Being inactive may increase arthritis problems. Many people who have arthritis are less fit, weaker and less flexible and have more pain than necessary due to the complications of inactivity. Pain, stiffness, fatigue and the fear of doing harm can make it difficult to be physically active with arthritis. For the person with arthritis, however, an appropriate exercise program is very important.

WHAT KINDS OF EXERCISE ARE HELPFUL AND SAFE?

Research shows that many people with arthritis can safely participate in appropriate, regular exercise programs and achieve better aerobic fitness. Low impact exercises, walking, swimming and water aerobics may be particularly well tolerated by people with arthritis. The water provides an additional benefit since the buoyancy decrease the effects of gravity so there is less weight put on the joints. This can enable you to tolerate more activity in the aquatic environment. Improved strength, endurance and flexibility, and better ability to walk or perform daily tasks are all benefits of exercise.

There are three major types of exercise. Each plays a role in maintaining or improving health and fitness, and reducing arthritis-related disability and pain.

Flexibility or stretching: Gentle, low intensity exercises performed daily to maintain or improve range of motion are the foundation of most therapeutic exercise programs and also are important in recreational or fitness exercise. Adequate flexibility improves function and reduces the chance for injuries.

Muscle conditioning (strength and endurance): These are more vigorous than flexibility exercises and are usually done every other day. They are designed to ask the muscle to work a bit harder than usual. This extra workload may come from lifting the weight of the arm, leg or trunk against gravity, or using weights, elastic bands or weight machines for more resistance. Muscles adapt to the new demands by getting stronger and/or becoming capable of working longer to decrease pain in the joint.

Cardiorespiratory or aerobic conditioning: These include activities that use the large muscles of the body in rhythmic and repetitive movements. Aerobic exercise improves heart, lung and muscle function. It is also the kind of exercise that has benefits for weight control, mood and general health. Examples of aerobic exercise are walking, swimming, aerobic dance, aquatic exercise, bicycling or exercising on equipment such as treadmills, rowing machines, Nordic track or elliptical trainers. Daily activities such as mowing the lawn, raking leaves, sweeping the driveway, playing golf or walking the dog are also aerobic exercise depending on the intensity level.

The most effective and safest intensity for aerobic exercise is moderate exertion. Moderate exertion means the exerciser can speak normally, doesn’t get out of breath or over-heated and can carry on the activity at a comfortable pace.

Current recommendations for regular aerobic activity are for 30 minutes of moderate aerobic activity on most days of the week. Important news for persons with arthritis is that this can be accumulated in three 10-minute periods of activity over the course of the day for the same health benefits as one continuous 30-minute session.

HOW TO CHOOSE THE BEST EXERCISE PROGRAM

A comprehensive exercise program for a person with arthritis includes flexibility, strengthening and aerobic activities. The content and progression of the program depends upon individual needs and capabilities. Persons with long-standing or severe disease or multiple joint involvement should undertake exercise in collaboration with the health care team so it is individualized to your specific needs. The most successful exercise programs begin with the knowledge and support of people like rheumatologists who are experienced with both arthritis and exercise.

Referrals to occupational and physical therapy may be useful to learn exercises that are safe and to teach you to adapt and progress your program as needed. Remember to include a variety of activities to prevent boredom and remain consistent. Some ways to increase compliance including using your support network by exercising with a friend or joining community based programs for arthritis. Your local Arthritis Foundation is an additional source of information on local exercise programs for arthritis patients. The Arthritis Foundation has an exercise program called People with Arthritis Can Exercise (PACE) and an aquatic program called Arthritis Foundation/YMCA Aquatic Program (AFYAP)).

FOR MORE INFORMATION CONTACT OUR PHYSICAL THERAPY DEPARTMENT AT 818-996-4077 FOR AN APPOINTMENT.

Adopted from the ACR web site. This site is full of useful information on Arthritis and related diseases.( http://www.rheumatology.org/ )

RTMC Therapy Center is dedicated to the total rehabilitation of our patients. Our knowledgeable and friendly Physical Therapists and Therapy Assistants want to provide you with the highest level of care. They all have a special interest, training. and years on experience in treating arthritic, orthopedic, and muscle problems. Treatment consists of a combination of technological modalities and manual ("hands-on") procedures. We also emphasize teaching how to avoid re-injury and re-occurrence of health problems.

Individualized treatment programs encompassing all aspects of rehabilitation are performed in a friendly, cheerful atmosphere.

Physical Therapy

Massage Therapy

Occupational Therapy

Poor Posture Treatment

Hand Therapy

Return to Work Evals

Fibromyalgia Treatment

Corporate Fitness

Neurological Rehabilitation

Work Injury Management

TMJ Treatment

Auto Injury/Whiplash Treatment

Sports Injury Treatment

Durable Medical Equipment

Our facilities include the following

Private rooms

State-of-the-art equipment

Shower facilities

Convenient parking

LOW LEVEL LAZER THERAPY (LLLT)

LLLT can be very effective for:

Chronic & Acute (traumatic) pain
Neck & Back Pain
Myofascial/Musculoskeletal Pain
Painful Trigger Points
Carpal Tunnel Syndrome
Sports Injuries
Frozen Shoulder/Adhesive Capsulitis
Headaches
Non-healing Ulcers

Bone Donor Sites
Tendonitis Scars & Keloids
Fibromyalgia
Diabetic Neuropathy
Rheumatoid & Osteoarthritis
Tennis/Golfer Elbow
Joint Sprains
Dental Disease - TMJ
Bursitis
Migraines
Wound Healing
Post-surgical/Suture Sites

Low-level lazer therapy, is an extremely safe lazer that consists of light energy that can:

Stimulate the release of ATP, the major source of energy for all cells. Increases in ATP allow cells to accept nutrients faster and get rid of waste products faster by increasing the energy level in the cell. ATP provides the chemical energy that drives the chemical reactions of the cells.
Increase vascularity (circulation) by increasing the formation of new capillaries, to replace damaged ones. These new capillaries speed up the healing process by carrying more oxygen, as well as more nutrients needed for healing, and they can also carry more of the waste products away.
Stimulate the production of collagen, which is the most common protein found in the body. It is essential to repair damaged tissue and to replace old tissue. Collagen is the substance that holds cells together, in particular the fibers of tendons, ligaments, and the fascia. By increasing the collagen production less scar tissue is formed at the damaged site.
Stimulate fibroblastic activity, which aids in the repair process. Fibroblasts are present in connective tissue and give rise to precursor cells, which form the fibrous, binding and supporting tissues of the body.
Stimulate the release of endorphin, enkephalin, and dynorphin, which are the body's natural pain killing chemicals, and the body's own long-term pain fighting chemicals.
Reduce the excitability of nervous tissue.
Accelerate the lymphatic system activity. Edema, which is the swelling process of the body, has two basic components. The first is a liquid part, which can be evacuated by the cardiovascular system. The second is comprised of proteins, which have to be evacuated by the lymphatic system. Research has shown that the lymph vessel diameter and the flow of the lymph system can be doubled with the use of light therapy. The venous diameter and the arterial diameters can also by increased. This means that both parts of edema (liquid and protein) can be evacuated at a much faster rate to relieve swelling.
Stimulate macrophages; large white blood cells that can each engulf hundreds of bacteria and other foreign matter. Macrophages are involved in cell-mediated immune responses. They are drawn to inflamed areas and are particularly important in the body's defense against chronic infections.
Increase phagocytosis, which is the process of engulfing and destroying microorganisms and cellular debris. This is an important part of the infection fighting process, which must occur for the healing process to take place

In summary, the lazer, which provides a specific light source, stimulates an increase in the cell's mitochondrial ATP production, which enhances and moderates cell activity. LLLT has a positive influence on cell proliferation, the function of immune cells, and the lymphatic and vascular systems. The result is wound and injury healing, which is greatly improved, and the healing process takes dramatically less time to complete.

LLLT has also proven effective in reducing both acute and chronic pain. The lazer increases the distal latency of sensory nerves, which corresponds to a decrease in sensory nerve conduction velocity, and helps explain the pain relieving effects of lazer irradiation. Other factors also play a critical role in LLLT reducing pain levels.

This technology can also be safely applied directly over the spinal vertebrae, even over hardware and/or stimulators that have been surgically placed. Ultrasound and electrical stimulation, in comparison, are contraindicated for clinical applications directly over the spine. This means low-level lazer therapy provides you with a safe and effective, non-invasive, and pain-free option for relieving your back pain.